Policy shift: Global Fund downsizes TB programme’s federal staff

Opts for post-devolution strengthening of provinces


Our Correspondent July 21, 2016
GF-supported programmes in the country have tested and treated over 756,000 people for the disease.. PHOTO: REUTERS

ISLAMABAD: The Global Fund (GF) has started downsizing contractual staffers at the National Tuberculosis Control Programme’s federal level office.

About 138 staff members were previously working with the programme. Only 67 technical staff members will continue to work, while the rest, mostly lower grade employees, are being issued termination letters, a staffer informed.

“The services of lower grade staff, hired by senior officers for assistance, have been terminated. The move was under consideration for a while to help make the programme more effective. The fund believes that after devolution, it should strengthen the provinces, where implementation actually takes place. The role of federal office is now limited to policy decisions and monitoring, so the office does not need droves of staff,” he said.

Ammara Omer, communication and media coordinator for the programme, said things were not clear yet as some staff members were delivered letters on Monday and some would be informed later. She said the downsizing was under consideration for a while to reduce spending and run the programme more efficiently as the fund plans to strengthen provincial programmes.

The GF supports national level programmes on HIV/AIDS, TB, and malaria. Pakistan ranks fifth on the list of high-burden TB countries and accounts for 60 per cent of the Eastern Mediterranean Region load of the World Health Organisation (WHO). The prevalence rate is 342 cases per 100,000 and the incidence rate is 275 cases per 100,000. The WHO estimated that the TB mortality rate was 27 deaths per 100,000 people in 2013. Death rates have declined in the country by 60 per cent in comparison to 1990, when it was 69 per 100,000. Despite this decline, the total number of cases remains high.

According to an audit report of the fund from September 2015, the health system in the country had been decentralised, giving more autonomy to provincial governments. “However, GF supported programmes are implemented through federal programmes at national level. This may affect accountability, sustainability, oversight and impact of the GF supported programmes in the long term,” it said.

Challenges in the country include recent changes to the constitution, a vast geographical area with limited infrastructure and human resources for health, and security challenges in FATA, Khyber-Pakhtunkhwa and north-east Balochistan, the report stated.

GF-supported programmes in the country have tested and treated over 756,000 people for the disease.

Published in The Express Tribune, July 21st, 2016.

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